The limits, challenges and opportunities of safeguarding children in the context of primary care

The sexual health of young people is a concern for policy makers and practitioners alike in Scotland. Some young people are particularly vulnerable to the adverse consequences of early sexual behaviour and as such are widely recognized to be one of the most important groups for reproductive health interventions (Cowen 2002). In 2005, there were seven births for every 1000 women under 16 years (ISO Scotland Publications 2007) while in 2003, 25 per cent of young Scottish women aged under 20 years reported having had a pregnancy terminated (Scottish Executive 2006a). Moreover, abortion rates in all teenage age groups are rising. especially in the under 16s (ISO Scotland Publications 2007). Approximately one in seven attendances to Genito-urinary Medicine Clinics (GUM) are by young people aged under 20 years and between 2002 and 2003 there was a 40 per cent increase in Chlamydia diagnoses in females under 15 years (Scottish Executive 2006a). Over the last two decades, the sexual health ofyoung people has seen virtually no improvements (ISO Scotland Publications 2007; Viner and Barker 2005), although the availability of information, education and services is improving throughout Scotland and there is no sign of further worsening ofthe situation (Scottish Executive 2006a).